How to self Treat

Sedentary office based work combined with stress poses a high-risk factor for developing chronic pain. We are under increasing pressure in the workplace where goals and targets are often put before wellbeing.
When a person’s work is target driven it’s common for their awareness to be with the goal rather than the process. If people aren’t meeting their targets they often push themselves, working harder and at a faster pace. In this process you can often lose touch with how your body is feeling. Many of my clients find that they’ve been running on adrenaline in a pattern of continuous hard work with little rest. With this amount of stress the nervous system becomes sensitive and muscles tense, making the body more vulnerable to pain. Many people get stuck in a cycle where pain in the workplace compromises performance leading to more stress, fear of job security and ongoing discomfort.
Physiotherapy can give you the tools to bring relaxation into your body on a daily basis, allowing you to continue working whilst maintaining an increased awareness of tension and how to control it.
How can I control tension?
If you feel pain, let this be a kind reminder to put yourself first and job second. A really easy way to reduce tension is through simple relaxation exercises. Try taking a soft breath in followed by a soft elongated breath out through the nose whilst feeling your body melt and relax. You can focus this on specific areas of your body such as the neck and shoulders. Build this into a pattern that suits your working day, perhaps during your break, when you’re getting a drink or by using a reminder ‘bell’ app on your computer. Many of my clients have been amazed by this simple technique that when used regularly can have such dramatic effects.
This article was written by Michael Otto BSc MCSP
“I am a physio based in Exeter and Totnes with an interest in chronic pain. I have a holistic approach that draws on many approaches one of which is the use of mindfulness based relaxation in the workplace.”
Michael Otto
Chartered Physiotherapistwww.ottophysio.co.uk

Why You Should Avoid Sitting For Too Long

Hello << Test First Name >>Research has suggested that remaining seated for too long is bad for your health, regardless of how much exercise you do.

Studies have linked excessive sitting with being overweight and obese, type 2 diabetes, some types of cancer, and premature death.

Prolonged sitting is thought to slow the metabolism, which affects the body’s ability to regulate blood sugar, blood pressure and break down body fat.

Many adults in the UK spend more than seven hours a day sitting or lying, and this typically increases with age to 10 hours or more.

This includes watching TV, using a computer, reading, doing homework, travelling by car, bus or train – behaviours referred to as sedentary – but does not include sleeping.

Experts believe there is something specific about the act of sitting or lying for too long that is bad for our health.

One of the largest pieces of research to date on the subject – involving almost 800,000 people – found that, compared with those who sat the least, people who sat the longest had a:

112% increase in risk of diabetes

147% increase in cardiovascular events

90% increase in death caused by cardiovascular events

49% increase in death from any cause

How much sitting is too much?

The advice is clear: to reduce our risk of ill health from inactivity, we are advised to exercise regularly – at least 150 minutes a week – as well as reduce time spent sitting or lying.However, there is currently not enough evidence to set a time limit on how much time people should sit each day.

What Can You Do?

Adults aged 19 to 64 are advised to try to sit down less throughout the day, including at work, when travelling and at home.

Sciatica

Hello << Test First Name >>Sciatica is the name given to any sort of pain that is caused by irritation or compression of the sciatic nerve. The sciatic nerve is the longest nerve in your body. It runs from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet. When the sciatic nerve is compressed or irritated, it can cause pain, numbness and a tingling sensation that radiates from your lower back and travels down one of your legs to your foot and toes. The pain can range from being mild to very painful, and may be made worse by sneezing, coughing, or sitting for a long period of time. Some people with sciatica may also experience muscle weakness in the affected leg. While people with sciatica can also have general back pain, the pain associated with sciatica usually affects the buttocks and legs much more than the back. In the vast majority of cases, sciatica is caused by a herniated or “slipped” disc. This is when one of the discs that sit between the bones of the spine (the vertebrae) is damaged and presses on the nerves. You can minimise your risk of developing a slipped disc or back injury that could lead to sciatica by adopting a better posture and lifting techniques at work, as well as stretching before and after exercise, and exercising regularly. Many cases of sciatica will pass in around six weeks without the need for treatment. However, a combination of things you can do at home – such as taking over-the-counter painkillers, exercising and using hot or cold packs – may help reduce the symptoms until the condition improves. In more persistent cases, it may be beneficial to consult a Physiotherapist to gain recovery quicker.

Are Tight Hip Flexors and Hamstrings causing your Back pain?

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Your hip flexors and hamstrings are among the most important groups of muscles in the body. They are necessary for the long term mobility and stability of your lower body. Healthy and well-conditioned hip flexors and hamstrings are key for the prevention of hip, knee and lower back issues. The health of your lumbar spine is directly affected by the action of the hip flexors and hamstrings. When there is an imbalance present in either of these muscle groups, the lower back can easily be subject to strain and injury. Corrective action is necessary to reverse this imbalance and therefore reduce the risk of injury to the spine. In most cases, people who experience lower back pain usually have accompanying tightness and imbalances in the various muscles. For example, it has been well established in both in the literature and among health professionals that tight hamstrings are one of the primary contributors to chronic lumbar pain. It is very rare to have chronically tight (or short) hamstring muscles and NOT suffer lumbar pain. The hamstring muscles are a group of very strong and large muscles which are often poorly maintained. It can be very challenging to keep them well conditioned, even under ideal situations. Tight hamstrings and hip flexors will often occur together. The strong pull of tight hip flexors can lead to an anterior pelvic tilt. This forward tilt of the pelvis causes an increased pull on the hamstrings which contributes to tightness of the muscle group. To maintain the normal and proper curvature of the spine, the muscles which are located in front and behind the pelvis must act and function in a balanced fashion throughout your daily activity. In doing this, they keep the pelvis in a neutral and safe position. In order to reduce the discomfort of lower back pain, your hip flexors and hamstrings should be exercised in many different ways. This requires several different positions, stretches and movements.

Could Your Headache Be Coming From Your Neck?

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Like back pain, headaches are one of the most common physical complaints amongst the general population. Most headaches are harmless and will resolve on their own, but they can occur for a variety of reasons. The International Headache Society classifies four types of headaches: tension headaches, migraines, secondary headaches (meaning they are caused by some other factor that could include sinuses, disease, fever, tumors, etc.), and cranial neuralgia.
The most common type of headache in adults is a tension headache and can occur because of poor posture, neck or jaw problems, fatigue and stress. Any of these can cause tension in the muscles at the base of the skull, and this tension can cause pain to radiate into the top of the head, along the temples, or behind the eyes.
A physiotherapist can treat tension headaches by first discovering its cause. To do this, they will ask questions about any previous injuries as well as the patterns and behaviors of your symptoms. Then they will look at the range of motion in your neck, shoulders and other relevant parts of your body. They will analyse your posture in a variety of positions and use hands-on techniques to assess the mobility of the muscles and joints in your neck.
Then, they can use this information to help you change the causes of your headaches. Depending on an individual’s particular case, this can involve manual techniques that will improve mobility of muscles or joints. They will also likely teach you exercises to work on your own mobility at home. Often, our postures and daily routines cause us to develop over-worked and under-worked muscles. A physio is likely also to teach you exercises to strengthen the under-worked muscles. All of this will help you to understand and maintain better posture. If necessary, an examination of the mechanics used at your workstation or home office can help you to maintain your improved posture when in one position for prolonged periods.
If you suffer from headaches, you don’t have to. There are physios who would be glad to help you get to the bottom of what can be a very debilitating problem.

Shoulder Instability

Hello << Test First Name >>The shoulder girdle is made up of 3 bones, the scapula (shoulder blade), the humerus (upper arm bone) and the clavicle (collar bone). The shoulder has the greatest range of motion of any joint in the body but this places it at the greatest risk of dislocations.

Shoulder instability is when the ball and socket joint is not controlled well. When the ball is sliding around it’s socket too much it can cause pain and in some cases come out of the socket and dislocate. Sometimes the ball does not completely dislocate and is only partially out and can feel locked. With a wiggle it often returns to its normal position. This is called subluxation.

To help improve the shoulder’s stability, the joint is supported by a thickened rim around the socket called a labrum, which deepens the shallow joint. The capsule around this joint is also reinforced by ligaments which become taught at the end range of all shoulder movements. When the ligaments become tight they also send important messages to the brain so that it can coordinate how the muscles around the shoulder move.

There are 4 very important muscles around the shoulder call the Rotator Cuff: supraspinatus, infaspinatus, teres minor and subscapularis. They are constantly adjusting to maintain the ball safely in the socket. They act a bit like dynamic ligaments throughout shoulders movement. They stabilise the joint during functional tasks of the arm, such as writing, driving and using the computer when the ligaments may not be tight.

There are 3 types of shoulder instability. The most common form of instability is caused by trauma, such as a fall. The large force causes structural damage to the ligaments and socket rim (labrum). This can lead to repetitive dislocations in some people. Shoulder rehabilitation may reduce the chances of this by training the rotator cuff to fully recover and compensate. In the younger population (below 28 years old) the chances of re-dislocation are much higher and they may require surgery.

The second type of instability is caused by excessive laxity of the shoulder ligaments and poor muscle control. This is not only of the rotator cuff, but also the muscles that control the scapula on the rib cage and to the rest of the body. It is difficult to keep the ball in a socket that is not controlled. This instability is known as atraumatic instability. It requires very specialist rehabilitation to achieve the complex muscle control. In some rare cases surgery can aid the muscle retraining process by tightening up the capsule and ligaments.

The third type is very rare and called “abnormal muscle patterning”. This is when the big powerful muscles that attach around the shoulder, activate inappropriately and out of sequence. This causes very large forces that the rotator cuff simply cannot compete with. This type of instability requires very specialist physiotherapy. We aim to reteach these muscles to activate in a normal way and rewrite their programming. Occasionally, the first 2 types of shoulder instability may develop these characteristics and it is important that this is identified early and addressed.

Due to the complex nature and wide spectrum of symptoms of shoulder instability, shoulder surgeons and Physiotherapists work very closely together to manage this condition.

Self-Myofascial release (SMR)

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Self-myofascial release (SMR) also known as self-massage can be utilised to release muscle tightness or trigger points at home. This method can be performed using a foam roller, massage ball or your own hands.
What is myofascial release? Fascia is a sheet of connective tissue fibres under the skin that attach to muscles to stabilize and separate them from other internal organs. The fascia can become stressed from repetitive movements, inflammation, or injuries causing acute strains and sprains. This poor condition of the fascia can lead to the formation of adhesions, commonly known as trigger points or ‘knots’. Trigger points can be felt as a knot in the muscle, and can refer tightness and or pain throughout connecting areas of the body. This abnormal state of fascia in the form of knots can lead to muscle imbalances, incorrect posture, and can cause reduced blood-flow to the surrounding tissues and muscles; preventing recovery.
Myofascial Release is a safe and very effective hands-on technique that involves applying gentle sustained pressure into the Myofascial connective tissue restrictions to eliminate pain and restore motion. Myofascial release can also aid in the recovery of muscles and assist in returning them to normal function. Normal function means your muscles are elastic, healthy, and ready to perform at a moment’s notice. Myofascial release (MFR) therapy focuses on releasing muscular shortness and tightness. There are a number of conditions and symptoms that Myofascial release therapy addresses.

How does it benefit my body? The goal of self Myofascial release (or SMR) is to relieve the tension caused by these trigger points. In return, self Myofascial release benefits include:

Improved Range of Motion – SMR works to restore proper range of motion by repairing the weak and tight fascia causing the trigger point.

Improved Oxygenation of Surrounding Muscles and Tissues – More blood flow to the adjacent areas means quicker recovery time and more efficient neuromuscular function.

Reduced Pain and Tightness – Going through your day, you might notice tight points in your legs, buttocks, and areas of your back and neck. Performing SMR on these points can help to reduce pain and tightness.

Essentially you are using these different shaped devices such as a foam roller to put pressure on and stimulate trigger points and knots. The fascia adhesions can be broken down, restoring mobility and reducing any pain and tightness you may have been experiencing in the area.
General Guidelines for using a foam roller

Spend 1-2 minutes per self myofascial release technique and on each each side (when applicable). When a trigger point is found (painful area) hold for 30-45 seconds.

Keep the abdominal muscles tight which provides stability to the lumbo-pelvic-hip complex during rolling. Remember to breathe slowly as this will help to reduce any tense reflexes caused by discomfort.

What Is Osteoarthritis- OA

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Osteoarthritis (OA) is the most common type of arthritis caused by wear and tear of a joint. It is associated with a breakdown of cartilage in joints and can occur in almost any joint in the body, however most commonly occurs in the weight-bearing joints of the hips, knees, and spine. Cartilage normally provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint and therefore stiffness.What causes osteoarthritis?

Osteoarthritis occurs when there is damage in and around the joints that the body cannot fully repair. It’s not clear exactly why this happens in some people, although your chances of developing the condition can be influenced by a number of factors, such as your age and weight. Osteoarthritis usually develops in people over 45 years of age, although younger people can also be affected. It is commonly thought that osteoarthritis is an inevitable part of getting older, but this is not quite true. You may in fact be able to reduce your chances of developing the condition by doing regular, gentle exercises and maintaining a healthy weight.

Who’s Affected?

Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genetics.Managing osteoarthritis

Osteoarthritis is a long-term condition and can’t be cured, but it doesn’t necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms.
Mild symptoms can sometimes be managed with simple measures including regular exercise to ensure the muscles surrounding the joint are in good strength to support the body weight, losing weight if you are overweight, wearing suitable footwear and using special devices to reduce the strain on your joints during your everyday activities.
If your symptoms are more severe, you may need additional treatments such as painkilling medication and a structured exercise plan carried out under the supervision of a physiotherapist.
In a small number of cases, where the above treatments haven’t helped or the damage to the joints is particularly severe, surgery may be carried out to repair, strengthen or replace a damaged joint.

Functional Movement System

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FMS is an American-based company that is bringing about a paradigm shift in how we conduct exercise and rehabilitation. FMS stands for functional movement systems, and it provides a tool to systematically identify movement limitations and asymmetries. To do this, it uses two different tools: the Functional Movement Screen and the Selective Functional Movement Assessment (SFMA). The SFMA is for people who have pain and should be conducted by a qualified healthcare provider. The FMS is also used to evaluate movement and can identify patterns that provoke pain. But it can be performed by a broader scope of individuals, including healthcare providers but also personal trainers, strength coaches, and exercise specialists, just to name a few.
The FMS is a relatively new service that we are providing at our Easy Gym and Gang Warily locations. You can contact one of our physios directly to schedule one, or we conduct these screens free and open to gym members at either location.What is the Functional Movement Screen?

It is a series of 7 movement patterns that look at the basics of human movement. Three are in weight bearing; four are on the floor. Three involve the basic foot positions of sport; two are for flexibility; and two are for stability. For each movement pattern, we are looking for asymmetries between the right and left side or limitations in the ability to perform the pattern. Each pattern is given a score between 0 and 3, with a maximal score of 21, and an average score of 14-16.Why does this matter and why would I want one?

The key with any exercise program is to get stronger or fitter without causing other problems. But what if that isn’t happening? What if you want to get back to running after a period of time away from it, but you don’t want to hurt yourself? Or what if you keep trying to return to the sport you love, but you keep causing the same injury over and over again or a different injury every time? There is a very good reason for this. You just may not know what it is yet. By using the FMS, we will look at the basics of human movement, and see how well you, as a human, move. You will have certain tests that are really easy for you and possibly others that seem next to impossible. But you are only ever as strong as your weakest link. The FMS will help us identify what this is so that we can help you change it, and thereby, change your outcomes.
Likewise, what if you regularly lift weights in the gym but you never seem to see a difference in your performance, whether that’s in a sport or simply with daily routines? Participating in an FMS can help you identify where your weaknesses are so that you can alter your workouts to address them. Doing what you are good at does not make you better. Doing what is hard until it’s not hard any longer does make you better. If you have limited movement patterns or are working around a pre-existing problem, you will never see the changes you are looking for. An FMS will help you identify where these limitations are and ways to change them. It also gives you objective measurable ways to judge your progress.
An FMS can also identify pain. You should not train on top of pain. Pain changes the way we move in unpredictable ways. Whether you realize it or not, pain causes you to compensate and move in less than efficient patterns. The pain needs to be resolved before a pattern is regularly repeated. This can only cause more problems. Additionally, sometimes, we have pain that resolves, but we don’t necessarily resolve our compensations. Sometimes, we don’t even realize that we ever started to compensate in the first place, so we have no idea that we are moving in an altered way. An FMS can help us to identify patterns that cause pain. An SFMA or a qualified provider can help you to identify sources of pain.
To summarize, the FMS helps us to identify two main things. One, which aspects of movement need to be addressed to have the biggest impact on performance. Performance could be athletic performance, but it doesn’t have to be. It could also be squatting to retrieve items from a low shelf or reaching into an overhead cabinet or any other movement pattern that we use in everyday life. And two, it helps us to determine where a person might break down. It helps us see a potential for injury before that injury occurs, so we can stop the process and prevent it. In participating in an FMS, you will learn one of three things. Either, you are good; keeping doing what you are doing. Or, how to tailor a workout program to better meet your goals. Or lastly, that you have some underlying issues that you would be better off to address before increasing loads or repetitions. Hopefully, this has shed some light on the FMS, in general, and also, some of its benefits.